I am not a nun, I am a midwife: maternity care in a “modern” Ireland

I attended a protest at the Department of Health yesterday to highlight people’s outrage at the handing over of the new National Maternity Hospital site to the religious order of the Sisters of Charity. I went as a member of Midwives for Choice, and I expected to help hold the banner and maybe video our spokesperson speaking. As it happened she could not, fearful as she was of her job by speaking out against St Vincent’s Hospital Group. So it ended up that I had a microphone and a megaphone pointed in my direction. My reaction? I froze. My voice is an inside my head voice, for the most part; I can’t even speak up in small group conversations mostly. So for anyone who wanted to know why there were midwives behind a banner, here are my thoughts.

I’m already scared that I’m a nun. All the older nurses and midwives in our hospitals were trained by nuns and they tell of the iron fist, regimented care and much else. Sometimes with respect and awe, sometimes fear, sometimes relief that they are all but gone.

The church’s legacy is strong within our healthcare system. Many if not most hospitals in the state have some church connection (religious members on boards, etc). Yet the history of church-run institutions in this country reads like a horror story, from the Magdalene Laundries to the institutional schools. Say it slowly with me: the institutions of the Catholic Church are inherently misogynistic. Women’s bodies will always suffer under them. They are beyond redemption.

Finally, this is the generation where the church’s abuses are being exposed. We are sickened as a nation to our very core about the Tuam babies, symphysiotomies, Magdalene Laundries, the abuse of our children by priests and nuns. Finally we should have hope that our society will stand up and say no more, that we can extricate our institutions from the grasp of the religious. It will be a slow but worthwhile process. When we can get the church out of our government, our laws, our schools, our healthcare systems, our bodies, maybe finally we can have a humane secular society.

That’s what most of us were thinking, surely, in the wake of the Tuam babies case? Please save us from the church? Then what the hell is this move? It’s as Irish a decision as getting your kid baptised to have a family get-together… and maybe to get into the local school. Cop on, Ireland. Stop being so short-sighted, so disingenuous. If we know something is wrong – and by God we know the Sisters of Charity have done wrong – then let’s stand up against it.

As a midwife, my role in supporting women to make informed decisions around their care in pregnancy and childbirth is already curtailed by the patriarchal, over-medicalised, over-litigious, under-staffed, no-continuity, factory-model, fire-fighting maternity system in place here. But at least women in Ireland are starting to take back power, to demand evidence-based care and proper time to birth. Even if this is something that our systems literally cannot provide at present, at least there is an awareness that what we have now is not good enough.

It feels like a change, this last 10 years: women are coming together; midwives are coming together; there is a politicisation, a will to change, even if it can’t quite find traction within our systems yet. There is a recognition that the 8th Amendment is a barrier to proper maternity care; where the fetus and the woman have equal rights within our constitution, any perceived risk to the well-being of a fetus overrides even real and substantial risks to a woman’s health and well-being. Our National Consent Policy directly points to the 8th Amendment as being a reason why pregnant people do not have a legal right to informed consent and refusal of treatment. Women leaving this system will attest to being railroaded and sidelined within their own care (see Aims Ireland testimonials).

I work within the system as it is now. While, individually, I strive to do my very best for each woman I care for, I know that the system is letting them down. I know that women are leaving our maternity system traumatised and broken down. Childbirth itself is not an inherently traumatic event. It is what we do to women in the name of “safety”: ass-covering and over-intervention without proper thought, consideration, conversation and shared decision-making with the people whose bodies we care for.

This brings me back to my first point: I already fear that I’m a nun. When the Tuam babies story broke, as well as the horror and the disgust that we all felt, I had a sneaking fear lurking… Those nuns were midwives. What if I’m a nun? What if I were a nun in Tuam, entering the institution to try to do my best for the forgotten and ostracised single mothers. What if I was kind as I caught their babies and helped them to their mother’s breast. What if I was gentle as I cared for infants while their mothers worked, coming back to feed them on schedule. What if my heart hurt as I dried the tears of a mother whose baby was adopted out to America. What if I felt sick with fear as I saw too many little babies dying. What if I knew that they weren’t being buried so that the money for them would keep coming in. What if I turned a blind eye because I was just a little nun cog-in-the-wheel. Sometimes I fear that I’m just a little midwife cog-in-the-wheel.

So I have to go and hold banners. I have to add my face to pictures and my feet to marches. I have to overcome my fear of putting my job in jeopardy by being seen to be overly-political, overly-public, overly-outspoken. I have to find my voice as a midwife and encourage others to find theirs… even if I’m not quite ready for the microphone and the megaphone. I have to nod to pro-choice badge-wearers and pro-choice colleagues. I have to have small conversations in work and outside of it. I have to join Facebook groups, scribble my thoughts, cuddle my loved ones, help my pregnant friends, and I have to breathe and tell myself I am not a nun. I am a midwife. I am with-woman not with-institution, however hard that is in my everyday work. I will stay within the institution because free maternity care is a public right and should be available to all, not just those who can afford health insurance and private midwifery care.

Some day I dream of the true mind and body safety that comes with continuity of midwifery care for all women, and the true informed relational decision-making that can only happen when our maternity institutions are built back up to humane levels, free of the stranglehold of patriarchal and religious control – both constitutionally and structurally. We have a chance in Ireland to reject our broken past and to go forward with conscious intent to do the right thing. So Repeal the 8th Amendment. And take back the National Maternity Hospital from the Sisters of Charity.